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Thank you for completing the Wake Forest Student Health Survey

Your responses will help improve our service to you. To be entered in the drawing for a $25.00 VISA gift card, please complete the information below.

If you choose to participate in the drawing be assured there is no link between the survey and the information you provide on this form. The survey is completely anonymous.

Regardless, we appreciate you taking the time to critique your experience received at Student Health. If you have any questions, further comments or concerns, please do not hesitate to contact Darren Aaron, Associate Director, SHS at aarondo@wfu.edu or (336) 758-4381

If you wish to enter for a chance to win a weekly $25.00 Visa gift card, please submit the following information

This form DOES NOT tie into your submitted survey answers.

"*" indicates required fields

Please enter the date you visited Student Health
Please provide an email address to contact you when you win the $25.00 Visa Gift card
This field is for validation purposes and should be left unchanged.

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All drawings will be done on Monday mornings by noon for surveys collected the previous week. All winners will be notified via email as soon as possible. You will need to come to Student Health and pick up your VISA gift card in person.  The prize is non transferable, nor may the prize exchanged for other awards from Student Health or Wake Forest University.  In the event the prize is uncollected after thirty days, it will be forfeited. You may not win more than one prize every thirty days.